Potassium chloride

Macromineral·Vitamins & Minerals

Prevention and treatment of hypokalemia (e.g., from Frusemide, severe vomiting/diarrhea, DKA insulin protocols)

PBSMINERALSpan-K, Chlorvescent (effervescent)600 mg tabletS4+1

Max Dose

10 mmol/hr (IV)

GI Ulceration

HIGH RISK (PO)

Rapid IV

FATAL ARREST

Renal Adj.

MANDATORY

Rapid Summary

Overview

The primary intracellular cation. Essential for cardiac electrical stability. High-risk medication when given IV due to the potential for instant, fatal cardiac arrest.

Maximum Dose

Max 10 mmol/hour via peripheral IV line. Max 20 mmol/hour via Central Line with continuous ECG.

Clinical Focus

NEVER give IV Potassium as a rapid bolus. It is the lethal injection sequence. Must be heavily diluted and infused slowly via an infusion pump.

Bottom Line

Potassium chloride is the standard replacement for hypokalaemia, but IV infusion must never exceed 10 mmol/hr peripherally due to risk of fatal cardiac arrhythmia and requires cardiac monitoring.

Formulation & Access

Brand Names

Span-K, Chlorvescent (effervescent)

Oral Routes

Sustained-release wax-matrix tablets (600 mg = 8 mmol). Effervescent tablets (14 mmol).

Parenteral

Premixed IV bags (10 mmol/100 mL). Ampoules (10 mmol/10 mL) MUST BE DILUTED.

Prescribing & PBS

Unrestricted General Benefit (S4). Highly restricted ward protocols for IV.

Indications & Use

Primary

PBSTGA

Prevention and treatment of hypokalemia (e.g., from Frusemide, severe vomiting/diarrhea, DKA insulin protocols).

Clinical Place

Crucial electrolyte replacement to prevent malignant ventricular arrhythmias.

Quick reference

Class & Role

Macromineral — The primary intracellular cation.

Route / Formulation

Sustained-release wax-matrix tablets (600 mg = 8 mmol). Effervescent tablets (14 mmol). (Span-K, Chlorvescent (effervescent))

Usual Dose & Max

PO 1-2 tablets (8-16 mmol) BD or TDS. Must be taken upright with a full glass of water with meals. Max 10 mmol/hour via peripheral IV line.

Key Indication Doses

Hypokalemia (Oral): PO 1-2 tablets (8-16 mmol) BD or TDS. Must be taken upright with a full glass of water with meals. Hypokalemia (IV Peripheral): IV Infusion 10 mmol in 100 mL Normal Saline over 1 hour. Maximum rate is 10 mmol/hr. Hypokalemia (IV Central): IV Infusion 10-20 mmol/hr via CVC strictly in ICU with ECG monitoring. Renal Impairment: Do not give routinely if eGFR < 30. The kidneys cannot excrete excess, leading to hyperkalemia and death.

Best Uses

Potassium chloride is the standard replacement for hypokalaemia, but IV infusion must never exceed 10 mmol/hr peripherally due to risk of fatal cardiac arrhythmia and requires cardiac monitoring.

Avoid / Cautions

Pre-existing hyperkalemia, severe renal failure, Addison's disease, concurrent use of potassium-sparing diuretics.

Key Risks

Cardiovascular: Hyperkalemia (K+ > 6.0) causing peaked T waves, widened QRS, sine-wave ECG, and fatal ventricular fibrillation/asystole. HIGH — Severe chemical phlebitis/vein burning via peripheral IV. Gastrointestinal: Oral Span-K tablets can cause severe esophageal or gastric ulceration, perforation, and bleeding if they get stuck or sit on the mucosa without enough water.

Key Interactions

ACEi, ARBs, Spironolactone, Amiloride, NSAIDs, Tacrolimus. Co-administration drastically reduces renal K+ excretion, leading to massive hyperkalemia.

Monitoring

Ensure the peripheral IV line is flushing perfectly. Extravasation of potassium causes agonizing tissue necrosis. If the patient complains of burning, slow the rate or dilute further. Strict U&E monitoring. Always check Magnesium levels (must be normal for K+ to stay in the cells).

Clinical Pearl

Never mix IV Potassium in a bag of 5% Dextrose. The glucose in the bag will trigger the patient's pancreas to release insulin. The insulin will drive all the potassium directly into the cells, dropping the blood level and making the hypokalemia *worse*. Always run it in Normal Saline.

Access

Span-K, Chlorvescent (effervescent)600 mg tablet

Brand: Span-K, Chlorvescent (effervescent)
Formulation: Sustained-release wax-matrix tablets (600 mg = 8 mmol)

Potassium chloride

Macromineral·Vitamins & Minerals

Prevention and treatment of hypokalemia (e.g., from Frusemide, severe vomiting/diarrhea, DKA insulin protocols)

PBSMINERALSpan-K, Chlorvescent (effervescent)600 mg tabletS4+1

Max Dose

10 mmol/hr (IV)

GI Ulceration

HIGH RISK (PO)

Rapid IV

FATAL ARREST

Renal Adj.

MANDATORY

Rapid Summary

Overview

The primary intracellular cation. Essential for cardiac electrical stability. High-risk medication when given IV due to the potential for instant, fatal cardiac arrest.

Maximum Dose

Max 10 mmol/hour via peripheral IV line. Max 20 mmol/hour via Central Line with continuous ECG.

Clinical Focus

NEVER give IV Potassium as a rapid bolus. It is the lethal injection sequence. Must be heavily diluted and infused slowly via an infusion pump.

Bottom Line

Potassium chloride is the standard replacement for hypokalaemia, but IV infusion must never exceed 10 mmol/hr peripherally due to risk of fatal cardiac arrhythmia and requires cardiac monitoring.

Formulation & Access

Brand Names

Span-K, Chlorvescent (effervescent)

Oral Routes

Sustained-release wax-matrix tablets (600 mg = 8 mmol). Effervescent tablets (14 mmol).

Parenteral

Premixed IV bags (10 mmol/100 mL). Ampoules (10 mmol/10 mL) MUST BE DILUTED.

Prescribing & PBS

Unrestricted General Benefit (S4). Highly restricted ward protocols for IV.

Indications & Use

Primary

PBSTGA

Prevention and treatment of hypokalemia (e.g., from Frusemide, severe vomiting/diarrhea, DKA insulin protocols).

Clinical Place

Crucial electrolyte replacement to prevent malignant ventricular arrhythmias.

Quick reference

Class & Role

Macromineral — The primary intracellular cation.

Route / Formulation

Sustained-release wax-matrix tablets (600 mg = 8 mmol). Effervescent tablets (14 mmol). (Span-K, Chlorvescent (effervescent))

Usual Dose & Max

PO 1-2 tablets (8-16 mmol) BD or TDS. Must be taken upright with a full glass of water with meals. Max 10 mmol/hour via peripheral IV line.

Key Indication Doses

Best Uses

Potassium chloride is the standard replacement for hypokalaemia, but IV infusion must never exceed 10 mmol/hr peripherally due to risk of fatal cardiac arrhythmia and requires cardiac monitoring.

Avoid / Cautions

Pre-existing hyperkalemia, severe renal failure, Addison's disease, concurrent use of potassium-sparing diuretics.

Key Risks

Key Interactions

ACEi, ARBs, Spironolactone, Amiloride, NSAIDs, Tacrolimus. Co-administration drastically reduces renal K+ excretion, leading to massive hyperkalemia.

Monitoring

Clinical Pearl

Access

Span-K, Chlorvescent (effervescent)600 mg tablet

Brand: Span-K, Chlorvescent (effervescent)
Formulation: Sustained-release wax-matrix tablets (600 mg = 8 mmol)